UW scientists tout cancer treatment

There is, contend a small but devoted group of scientists, physicians and engineers. It's an ultrasound technique developed from military research done at a University of Washington lab originally created during World War II to work on torpedoes and sonar.

UW researchers are trying to get the technique, called high-intensity focused ultrasound, considered as a cancer therapy.

Scientists here have already produced a device using these high-energy sound waves to stop internal bleeding in major arteries or organs in a non-invasive way. A Seattle company is pursuing commercial development.

"We anticipate starting clinical trials in the U.S. in the third quarter of 2003," said Tom Anderson, vice president for clinical programs at Therus Corp.

Sound waves are a form of energy. Using multiple ultrasound sources, the waves pass harmlessly in the body until they converge on a focal point -- a tumor or bleeding artery, where the combined energy is great enough to either destroy the cancer cells or cauterize the wound.

Low-intensity ultrasound provides simultaneous imaging to precisely target the area under treatment.

Despite Seattle's lead role in developing this technique, the first clinical trials of the high-energy ultrasound device for stemming bleeding were done in Germany.

For cancer, this technique is now available only in China. A small number of cancer patients in Britain will be able try it soon with a clinical trial planned at Oxford University.

"The Chinese are three to five years ahead of us on this," said a frustrated Larry Crum, director of the UW's center for industrial and medical ultrasound at the Applied Physics Laboratory. "I don't know why we're not doing it here."

Crum and his colleagues are playing host to the second annual international symposium on therapeutic ultrasound in Seattle this week to present their data and make their case for moving the technology to the fast track. Crum participated in the first symposium in Chongqing, China, where the approach is in widest use as a cancer therapy.

The Applied Physics Laboratory, created in 1943 with a Navy grant, has become one of the world's leading research labs on sonar and ultrasound technology and has spun off numerous private companies. One of the world's largest manufacturers of diagnostic ultrasound machines, Bothell-based ATL, can be traced back to the UW lab. Philips Electronics recently acquired ATL.

But Crum said the U.S. cancer-treatment establishment has resisted taking a close look.

"The problem with most cancer therapies today is damage to the body. This method does not damage the body," said Dr. Feng Wu, who directs the program at Chongqing University.

Wu speaks this morning at the symposium, held through Thursday at the Washington Athletic Club. He will present clinical results from four years of using high-intensity focused ultrasound on a variety of cancers. He claims success even among patients who, with standard therapies, often have little chance of survival, such as those with aggressive pancreatic cancer.

Ultrasound, according to Wu, aids in fighting tumors that have spread beyond the primary site because, unlike chemo or radiation, it doesn't damage the patient's immune system.

It's expected to be a hard sell to the American medical community, however.

Dr. Robert Livingston, one of the lead oncologists at the UW, said using ultrasound to non-invasively destroy tumors sounds good but there's no evidence yet that it provides superior results. And there are some drawbacks.

"We want to be able to identify the cancer cells," Livingston said. Surgical removal of the tumor allows physicians to identify cell and tumor type, he said, which provides valuable information on how to proceed with patient care.

Dr. Todd Barnett, director of radiation oncology at Swedish Hospital Medical Center, agreed, adding that the use of high-energy sound waves should not be confused with the use of low-level waves for ultrasound diagnostics. "With this method, you're introducing a burn into the body," Barnett said. "I'm not sure that's better than surgery."

Crum has heard it all before. He notes that the medical community in Britain appears less skeptical, so much so that they've imported one of Wu's machines to do their clinical trial next year.

"It's been a hard slog getting this going in England as well, perhaps because it looks too good to be true," said Dr. Gail ter Haar, head of the therapeutic ultrasound unit at the Institute of Cancer Research in Surrey, England.

Ter Haar, one of the principal investigators of the clinical trial at Oxford that will begin in about a year, said they will try it first on liver, kidney and prostate cancers.

The science behind the use of high-energy sound waves to destroy cancers isn't new, Crum noted.

It goes back decades, largely to the work of Dr. Frank Fry in Indianapolis -- who will be receiving an award at this week's meeting for his pioneering work in therapeutic ultrasound.

Crum has friends with cancer, and he can barely contain his frustration that a technology he believes can help them -- a technology he and his colleagues developed here in Seattle -- is only available to patients in China. [Note: This sentence has been clarified since it originally appeared in print.]

"One of my best friends is dying of cancer, and all the doctors can tell him is he's going to die," Crum said. "It's depressing."

He and his colleagues recognize they have some hurdles to overcome: The fact that this new experimental cancer therapy came not from academic medicine but from a physics lab devoted to military projects, that the best data come from a dubious source and immense regulatory and legal challenges to introducing any new drug or medical therapy.

But Crum and his associates at the Applied Physics Laboratory are a stubborn bunch.

"This is such a benign and promising treatment," he said. "I can't think of a good reason not to try it."